J Korean Orthop Assoc.  2019 Aug;54(4):317-326. 10.4055/jkoa.2019.54.4.317.

Comparative Study of Compliance for Venous Thromboembolism Prophylaxis (American College of Chest Physicians Guideline and American College of Orthopedic Surgeons Guideline) in High Risk Patients with a Venous Thromboembolism

Affiliations
  • 1Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea. orthowon@gmail.com

Abstract

PURPOSE
To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication.
MATERIALS AND METHODS
This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines.
RESULTS
The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery.
CONCLUSION
Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.

Keyword

compliance; venous thromboembolism; guideline; orthopedic procedure

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee
Compliance*
Hip Joint
Humans
Joints
Medical Records
Orthopedic Procedures
Orthopedics*
Retrospective Studies
Surgeons*
Thorax*
Thromboembolism
Venous Thromboembolism*

Figure

  • Figure 1 Flow chart of patients treated according to the American College of Chest Physicians guidelines. TKRA, total knee replacement arthroplasty; THRA, total hip replacement arthroplasty; HFS, hip fracture surgery.

  • Figure 2 Flow chart of patients treated according to the American College of Orthopedic Surgeons guidelines. TKRA, total knee replacement arthroplasty; THRA, total hip replacement arthroplasty; HFS, hip fracture surgery.


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